SECTION 554.1205. Physician Delegation of Tasks

(a) In a Medicare skilled nursing facility (SNF), except as specified in subsection (b) of this section, a physician may delegate tasks to a physician assistant, or an advanced practice registered nurse who:

(1) is acting within the scope of practice as defined by state law; and

(2) is under the supervision of the physician.

(b) In a Medicare SNF, a physician may not delegate a task when the regulations specify that the physician must perform it personally, or when the delegation is prohibited under state law or by the facility's own policies.

(c) In a Medicaid nursing facility, any required physician task may also be satisfied when performed by an advanced practice registered nurse or physician assistant who is not an employee of the facility but who is working in collaboration with a physician. Services must be provided in the context of applicable state laws, rules, and regulations governing the practice of an advanced practice registered nurse and physician assistants.

(d) A physician may delegate the task of writing dietary orders to a qualified dietitian who:

(1) is acting within the scope of practice; and

(2) is under the supervision of the physician.

(e) A physician may delegate the task of writing therapy orders to a qualified therapist who:

(1) is acting within the scope of practice; and

(2) is under the supervision of the physician.

(f) The physician assistant or advanced practice registered nurse providing care to a pediatric resident must have training and expertise in the care of children with complex medical needs.

Source Note: The provisions of this §554.1205 adopted to be effective May 1, 1995, 20 TexReg 2393; amended to be effective March 24, 2020, 45 TexReg 2025; transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871